“So where did the ALU (antimalarial drug) go?”
“I don’t know”
“Because we got it from pharmacy yesterday but the patients haven’t had any doses...”
“Uh huh”
“Did you take the drugs home?”
“The drugs are available.”
“Will the drugs be available on the ward by the time the patients need their next dose?”
“They will be available.”
“Right. And this won’t happen again?”
“The drugs will be available.”
“Ok, so would you like some tea?”
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| The isolation ward with cholera patient - it is as bad as it looks unfortunately |
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| One of the very good and very competent nurses on my ward (not one of those mentioned below!) |
The wonderful saying about accepting the things you can’t change and changing the things you can’t accept is a lovely idea. However, having now been in Tanzania for a while, the number of things I can’t accept are decreasing as I learn that accepting my own limitations is sometimes more important. It’s not been a bad couple of weeks, but as can be seen from the above discussion with one of the nurses on my ward, it’s not been ideal either. I have also had to speak with another nurse about turning up to work drunk.... every night this week! This is an ongoing problem and whilst I am under no illusion that things will change completely, I am hopeful that maybe the timing of alcohol intake can be altered a little so that it has less impact on patient care. A low point (and reason for the discussion) came when I had to ask a patient’s relative (who is also a nurse not just a random person who turned up on the ward) to draw up and give the injection I had prescribed for her relative. Having had a confused conversation with the nurse on duty, where even with my limited Kiswahili I could tell she was slurring words and repeating herself multiple times, I realised the chance of the patient getting the correct drug at the correct dose by the correct route was small. These are not easy conversations to have as a foreigner in a different language – they wouldn’t even be easy in England in English but I am hoping some kind of mutual understanding has been reached....
There have also been some lovely moments this week with patients on my ward. Occasionally we get patients coming from Mozambique and, whilst my Kiswahili is limited, my Kimakua is non-existent making communication difficult. Luckily (since none of the nurses on my ward speak kimakua either) the patient in the next bed has been translating for me and, when my Mozambique patient had to go and see the gynaecologist, she simply got a wheelchair for the other patient (who has a dodgy knee amongst other problems) and took her along. Luckily people are less concerned about confidentiality here and less phased by the thought of having intimate examinations with a stranger in the room! I may have kept the translating patient admitted for a little longer than was strictly necessary to avoid the need for mime in order to communicate with the lady from Mozambique.
In other news I have made it home. It’s cold. And dark. But, I’ve met up with my parents, I’ve had a bath for the first time in 7 months, I’ve had sausages with cheesy mashed potato and I am extremely happy. The journey home was wonderfully uneventful and the road was dry so it only took 9 hours to escape the south and get myself to Dar (see picture above to see what happens to the road when the rains come). I had a short moment of confusion in UK passport control where, after standing in a long non-moving line for a while, it occurred to me that being the only white person in the near vicinity probably wasn’t normal anymore and should have alerted me sooner to the fact I was in the wrong queue. So today I am off to buy some more climate-appropriate clothes – a pretty stressful prospect as it will involve tackling Brighton shops on a Saturday afternoon.
